| NPI | 1023776804 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 14986-33) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 23148530) |
| Enumeration Date | 2021-11-29 |
| Last Update Date | 2024-03-04 |